Police Department Personal History Statement Form (Page 20 of 22) in pdf

74. Have you ever used or possessed any illegal drug, controlled substance, or prescription drugs not lawfully

prescribed to you?

 Yes  No

If yes, give dates, location and circumstance _________________________________________________________________

75. I understand that the City of Boise is a “drug free” workplace and I will be subject to the drug test as outlined in Boise City “drug

free” workplace policy and as outlined in policies and procedures of the Boise Police Department.

Date: ________________

Applicant’s Signature ____________________________________________________________

76. Is there anything we have not discussed which YOU believe would have an effect on your background investigation?

_____________________________________________________________________________________________________

77. All applicants: We will be conducting an extensive investigation into your suitability for employment in this position. Please

describe in detail anything else you feel is important for your background investigator to know. ________________________

_____________________________________________________________________________________________________

I certify that all statements and information made by me in completing this form are true to the best of my knowledge. I personally

have completed this form and understand that deliberate errors or misstatements may cause my application to be rejected. I also

understand that erroneous information will negate any conditional offers and may result in my termination at a later date if I am hired.

Date: ______________________________Applicant’s Signature ____________________________________________________

Police Department Personal History Statement Form Page 20